Looking for support/advice for early days of new HRT

[Furryfeet]

I'm 45 and have had anxiety, insomnia and a sense of being 'not right' for a few months (plus other symptoms such as v heavy periods, iron deficiency, crawling skin) no history of mh issues. I've tried so many things to tackle this including AD's, Elleste Duet, combined pill and lots of lifestyle changes (no caffeine, lots of exercise, meditation, counselling, changes to work role) but it's been very persistent.

After seeing a Newson Health consultant last month she advised she thinks i'm definitely peri (and may be progestin intolerant) and she prescribed new HRT (Evorel 50 for 7 days, then Evorel 100 patches with the possibly of increasing to 1.5 patches in future) + utrogestan to follow in a few weeks.

On Sunday (day 11 of Evorel 100) I noticed a sense of greater calm and absence of the usual physical tension and this seemed to continue for a few days. Although sleep wasn't fully restored I felt more relaxed about it. This seemed to continue and then yesterday afternoon I felt so hopeful, upbeat and like I might be getting some of the 'old me' back, which was so exciting.

However, when I went to bed (still feeling elated) the palpitations returned and I didn't sleep so well and I've felt the knot in my stomach return today, and feelings of anxiety/apprehension which is so disappointing. It was almost as if a day of feeling happy left me wired and high and this tipped me back into anxiety.

I wonder could I still be a bit out of balance on the new regime? Has anyone else had a bumpy start to new HRT? Am I being impatient (which I think given my situation is understandable!)?

I'm actively looking at other circumstantial factors around family, work, relationship stressors as I feel I'm running out of ways to tackle these horrible feelings.

Hey there - I don't know why you've had no replies yet. Just wanted to offer you some support. There are a lot more knowledgable people than me on this forum so I think it might be better if they answer you. Your regime sounds very different from mine and so there is probably a lot of information your consultant has that is individual to you that I wouldn't know about. Like why they have decided you are progesterone intolerant and that sort of thing.

So I can't offer any advice on that.

But I can say that I've been on HRT about six months now and it's certainly taken me a bit of time to get a regime that works for me. It took me about four months! I've been on one that works for me for about 2 months now and feeling very good. So in answer to the question of whether people can have a bit of a bumpy time at first I think it can take a lot of people a bit of time to find the optimum for them. All our bodies are different and what stage we're at etc. New regimes also need a bit of a chance to settle down etc so it can take a while to sort out.

On the other hand, it takes a lot to get your head around all this stuff, so doing a bit of reading around about all the possible regimes there are and all the thinking surrounding them can't hurt. If you aren't feeling right or worse, don't be shy of going back to the consultant to see if they think it's the right regime or whether things need tweaking.

It was useful for me to keep a log. I got a big calendar I could write on and noted down how I felt day by day or anything unusual. It became clear to me what part of the regime wasn't suiting me. In my case I was using oestrogen patches twice weekly and adding in the progesterone part for 14 days in every 28. I had the most side effects in the progesterone part of the cycle and started to think I was progesterone intolerant. However, in the part of the cycle where I was on the oestrogen patches without the progesterone, although I felt cheerful and energetic, I was almost a bit too hyper and didn't sleep so well either due to restlessness and jitteriness. Whereas during the progesterone part of the cycle I was sleeping too heavily and had very vivid dreams but was also getting up to pee numerous times in the night. I found it very hard feeling so inconsistent in my sleep patterns. In my case I found moving from a cyclical to a continual regime (from higher doses of progesterone for part of the cycle to a lower but more continual dose of progesterone) really suited me. I also found it had a profound effect on my anxiety and sleep - and the latter is consistant and good now and the peeing through the night just stopped. However, there are reasons they prefer a cyclical regime at perimenopause and prefer the continual post-menopause. I'm under supervision and willing to put up with any extra checking and inconvenience etc, but my situation is only my situation. I'm just outlining it to say how one regime didn't work for me but another did.

Mine seems very different from your situation but I only mention it to get the ball rolling on your thread, to say you're not alone struggling to find the right answer in the early days and also to say that reading around and arming yourself with more knowledge of all the different regimes and keeping a log is really worth doing.

I hope someone better and more knowledgeable than me will be along shortly.

Aw, thanks so much for taking the time to reply Menopauseadventurer! I really appreciate it. I have read your post a couple of times as there’s a lot to it. The point about waiting is a simple and good one - I’m barely into double figure days on this new med!

In answer to your point about my progesterone intolerance, I think it’s because I have felt quite anxious on the pill in the past and very anxious when briefly I used a Nuva ring.

Interesting what you say about feeling energetic and jittery on oestrogen. I wonder if I’m experiencing some of this. I have tried utrogestan a couple of times in the past and it’s early days but sadly I don’t think I’ll be one of the people who finds it makes them sleep soundly. I seem to be a super rapid metaboliser and drugs don’t seem to ‘stick’ in my body. If this is the case I may research it further to see if there’s a workaround.

It’s a good idea re the diary. Even just casting my mind over the last couple of weeks. I think my sleep and anxiety may relate not just to hormones but the last couple of years have of course been difficult ones for lots of reasons. In short I think I might need a hobby. I’ve stopped work for a little while as my job has been demanding of late and my stress levels were high (+ bad sleep etc). Although I’ve done lots of the right things re healthy lifestyle, between watching my budget and navigating the post pandemic world, I think my days have lacked spontaneity, proper structure and joy. Twice when I’ve felt more relaxed and slept well have followed my involvement in community activities.

Thanks again!

…not to say that peri menopause symptoms don’t have a huge impact on my life right now, but I think I need to try to find a balance between sensible self-care and just kind of living my life